Individual
CATHERINE THEIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, APN, CCRN
Contact information
Practice address
225 E CHICAGO AVE # 21, CHICAGO, IL 60611-2991
(773) 724-1141
Mailing address
225 E CHICAGO AVE # 21, CHICAGO, IL 60611-2991
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
209018348
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209018348
IDFPR
IL
01
—
309013309
IDFPR
IL
Enumeration date
10/09/2018
Last updated
10/09/2018
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